Surgical Outcomes for Temporal Bone Malignancies

Introduction: Temporal bone malignancies are rare and aggressive, and decisions on the type of surgical treatment for these patients can be challenging. The objective of this study is to evaluate outcomes for patients undergoing surgery for temporal bone malignancies.

Methods: A single institution retrospective cohort study of patients undergoing surgery for malignancies surrounding and involving the temporal bone from January 1, 2016 to January 1, 2022 was performed. The primary outcome measure was overall survival. Secondary outcome measures included recurrence and 30-day readmission.

Results: Fifty patients were identified, 38 (76%) were male and 49 (98%) were white. The median age was 69 years (range 32 to 91). Patients commonly presented with otologic symptoms of ear mass, otalgia, otorrhea or hearing loss. Primary cutaneous squamous cell carcinoma (54%) was the most common tumor followed by salivary gland carcinomas. Twenty-seven (54%) patients underwent temporal bone resection, 17 (34%) patients had mastoidectomy, and six (12%) patients had wide local excision with canalplasty. Four patients were readmitted within 30-days of discharge for either flap necrosis or soft-tissue skin infection. Adjuvant radiation therapy (RT) was administered for 27 patients. Overall two-year survival was 70%. Temporal bone resection and adjuvant RT were associated with improved overall survival. Eight patients recurred at a median of 6 months.

Conclusions: Malignancies involving the temporal bone are rare and can be aggressive with poor survival outcomes and high morbidity. There was a trend for improved survival for patients who received temporal bone resection and adjuvant RT compared to those who did not. Further multi-institutional studies may be helpful in elucidating this trend and standardizing surgical management.